Provider Demographics
NPI:1346568714
Name:CIRA, COLLEEN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:COLLEEN
Middle Name:
Last Name:CIRA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9933 LAWLER AVE
Mailing Address - Street 2:SUITE 338A
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-3703
Mailing Address - Country:US
Mailing Address - Phone:847-329-9210
Mailing Address - Fax:708-681-9280
Practice Address - Street 1:800 AUSTIN ST
Practice Address - Street 2:EAST TOWER, SUITE 352
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60202-3439
Practice Address - Country:US
Practice Address - Phone:847-329-9210
Practice Address - Fax:708-681-9280
Is Sole Proprietor?:No
Enumeration Date:2010-05-11
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071-007895103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical